Sleep quality traits correlate with inflammatory markers in the breast tissue of women.

Background: Several mechanisms have been posited to play a role in the sleep and breast cancer association, including alterations in immune function, but evidence remains inconclusive. A closer look at how sleep quality traits affect the breast microenvironment may provide clues for molecular mechanisms underlying the link between sleep and breast cancer. We examined the association between sleep quality traits (sleep duration, sleep aids, and insomnia) and tissue-based protein levels and gene expression of several inflammatory markers associated with breast cancer.

User-centered and theory-based design of a professional training program on shared decision-making with older adults living with neurocognitive disorders: a mixed-methods study.

Background: We know little about the best approaches to design training for healthcare professionals. We thus studied how user-centered and theory-based design contribute to the development of a distance learning program for professionals, to increase their shared decision-making (SDM) with older adults living with neurocognitive disorders and their caregivers.

Methods: In this mixed-methods study, healthcare professionals who worked in family medicine clinics and homecare services evaluated a training program in a user-centered approach with several iterative phases of quantitative and qualitative evaluation, each followed by modifications.

Professional training on shared decision making with older adults living with neurocognitive disorders: a mixed-methods implementation study.

Background: Shared decision making with older adults living with neurocognitive disorders is challenging for primary healthcare professionals. We studied the implementation of a professional training program featuring an e-learning activity on shared decision making and five Decision Boxes on the care of people with neurocognitive disorders, and measured the program's effects.

Methods: In this mixed-methods study, we recruited healthcare professionals in family medicine clinics and homecare settings in the Quebec City area (Canada).

Assessing the Quality of Care Provided to Older Persons with Frailty in Five Canadian Provinces, Using Administrative Data.

Nous avons examiné la qualité des soins fournis aux personnes âgées fragiles dans cinq provinces canadiennes à partir de données administratives sur la santé. Dans chaque province, nous avons considéré les personnes âgées fragiles en fonction de deux cohortes : les personnes décédées et les personnes vivantes. Des règles de décision ont été utilisées pour déterminer quelles personnes étaient frêles, soit celles résidant en établissement de soins de longue durée, qui étaient en phase terminale ou dont le profil correspondait à deux des sept domaines identifiés.

Talking about treatment benefits, harms, and what matters to patients in radiation oncology: an observational study.

Background: Shared decision making is associated with improved patient outcomes in radiation oncology. Our study aimed to capture how shared decision-making practices-namely, communicating potential harms and benefits and discussing what matters to patients-occur in usual care.

Methods: We invited a convenience sample of clinicians and patients in a radiation oncology clinic to participate in a mixed methods study.

Key stakeholders' views on the quality of care and services available to frail seniors in Canada.

Background: Frail seniors often receive ineffective care, which does not meet their needs. It is still unclear how healthcare systems should be redesigned to be more sensitive to the needs and values of frail seniors and their caregivers. We thus aimed to describe key stakeholders' perspectives on the current healthcare and services available to frail seniors.

An isoform of AIF1 involved in breast cancer.

Background: Inflammation is a major player in breast cancer (BC) progression. Allograft-inflammatory factor-1 (AIF1) is a crucial mediator in the inflammatory response. AIF1 reportedly plays a role in BC, but the mechanism remains to be elucidated.

Tailoring and evaluating an intervention to improve shared decision-making among seniors with dementia, their caregivers, and healthcare providers: study protocol for a randomized controlled trial.

Background: The increasing prevalence of Alzheimer's disease and other forms of dementia raises new challenges to ensure that healthcare decisions are informed by research evidence and reflect what is important for seniors and their caregivers. Therefore, we aim to evaluate a tailored intervention to help healthcare providers empower seniors and their caregivers in making health-related decisions.

Methods: In two phases, we will: (1) design and tailor the intervention; and (2) implement and evaluate it.

Work Absenteeism and Presenteeism Loss in Patients With Non-Cardiac Chest Pain.

Objective: To assess work absenteeism and presenteeism, and to identify biopsychosocial predictors of these outcomes in workers with non-cardiac chest pain (NCCP).

Methods: This retrospective cohort study included 375 active workers consulting in an emergency room for NCCP.

Results: About 66% (247/375) of participants reported work absenteeism in the 3 months preceding the consultation, while 36% (134/375) reported presenteeism during the same period.

Caring for seniors living with dementia means caring for their caregivers too.

To improve the care of seniors living with dementia, current initiatives typically target better identification and treatment of the patient. Our recent survey, however, shows we should also focus more on the needs of the informal caregivers who care for this population in primary care settings. This three-round Delphi survey sought caregivers' views on the most frequent and difficult decisions that seniors with dementia, their informal caregivers, and health care providers face in primary care settings in the province of Quebec.

Twelve Lessons Learned for Effective Research Partnerships Between Patients, Caregivers, Clinicians, Academic Researchers, and Other Stakeholders.

Research increasingly means that patients, caregivers, health professionals, other stakeholders, and academic investigators work in partnership. This requires effective collaboration rooted in mutual respect, involvement of all participants, and good communication. Having conducted such partnered research over multiple projects, and having recently completed a project together funded by the Patient-Centered Outcomes Research Institute, we collaboratively developed a list of 12 lessons we have learned about how to ensure effective research partnerships.

Heart-focused anxiety and health care seeking in patients with non-cardiac chest pain: A prospective study.

Objectives: This study aimed to estimate the incidence of medical consultations six months after an emergency department (ED) consultation for non-cardiac chest pain (NCCP). It also investigated the role of heart-focused anxiety (HFA) and other factors in predicting an increased healthcare utilization in these patients.

Method: This was a prospective study of 428 patients who came to an ED with NCCP.

Diet quality indices in relation to metabolic syndrome in an Indigenous Cree (Eeyouch) population in northern Québec, Canada.

Objective: To assess associations between three diet quality indices and metabolic syndrome (MetS) in the Cree (Eeyouch) of northern Québec, Canada, as well as to evaluate their pertinence in this Indigenous context.

Design: The alternative-Healthy Eating Index 2010 (aHEI-2010), the Food Quality Score (FQS) and the contribution of ultra-processed products (UPP) to total daily dietary energy intake using the NOVA classification were calculated from 24 h food recalls. MetS was determined with the latest harmonized definition.

Psychometric validation of the household food insecurity access scale among Inuit pregnant women from Northern Quebec.

Background: Globally, food insecurity is a major public health concern. In North America, it is particularly prevalent in certain sub-groups, including Indigenous communities. Although many Indigenous and remote communities harvest and share food, most food security assessment tools focus on economic access.

Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers.

Background: Decision support tools build upon comprehensive and timely syntheses of literature. Rapid reviews may allow supporting their development by omitting certain components of traditional systematic reviews. We thus aimed to describe a rapid review approach underlying the development of decision support tools, i.

Involving members of vulnerable populations in the development of patient decision aids: a mixed methods sequential explanatory study.

Background: Patient decision aids aim to present evidence relevant to a health decision in understandable ways to support patients through the process of making evidence-informed, values-congruent health decisions. It is recommended that, when developing these tools, teams involve people who may ultimately use them. However, there is little empirical evidence about how best to undertake this involvement, particularly for specific populations of users such as vulnerable populations.

EXUDATIVE RETINAL DETACHMENT CAUSED BY A CHOROIDAL NEOVASCULAR MEMBRANE IN HALLERMANN-STREIFF SYNDROME.

Purpose: To report a case of exudative retinal detachment caused by a choroidal neovascular membrane in Hallermann-Streiff syndrome.

Methods: The authors report a 7-year-old white male with Hallermann-Streiff syndrome who developed exudative retinal detachments secondary to choroidal neovascular membrane that resolved after off-label use of intravitreal injections of bevacizumab 1.25 mg.

Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials.

Introduction: Exposure to high levels of endogenous estrogens is a main risk factor for breast cancer in women, and in observational studies was found to be inversely associated with physical activity. The objective of the present study is to determine the effect of physical activity interventions on sex hormone levels in healthy women.

Methods: Electronic databases (MEDLINE, EMBASE, CENTRAL), from inception to December 2014, and reference lists of relevant reviews and clinical trials were searched, with no language restrictions applied.

Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand-control-support and effort-reward imbalance models.

Objectives: A growing body of research has investigated the adverse effects of psychosocial work factors on blood pressure (BP) elevation. There is now a clear need for an up-to-date, critical synthesis of reliable findings on this topic. This systematic review aimed to evaluate the adverse effects of psychosocial work factors of both the demand-control-support (DCS) and effort-reward imbalance (ERI) models on BP among men and women, according to the methodological quality of the studies.

Detecting delirium and subsyndromal delirium using different diagnostic criteria among demented long-term care residents.

Objectives: To evaluate the impact of using different diagnostic criteria on prevalence rates of delirium and subsyndromal delirium (SSD) among demented long-term care (LTC) residents.

Design: Descriptive study.

Setting: LTC settings in Quebec City, Canada.

Accuracy of nurse documentation of delirium symptoms in medical charts.

The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor.

Prevalence of falls with minor and major injuries and their associated factors among older adults in long-term care facilities.

Aims and objectives.  The objectives of this study were to determine the prevalence of falls with minor and major injuries and identify their risk factors. Background.

Living in the community while waiting for an admission in long-term care: satisfaction with a transitional nursing home project.

This qualitative study took place in Quebec City, Quebec, Canada. The main objective was to evaluate satisfaction with a transitional program aimed at keeping seniors in the community while waiting for admission to a public long-term care facility. Semistructured interviews were conducted with 4 types of informants: seniors, family members, facility managers, and hospital or community care coordinators.

Prevalence and symptoms of delirium superimposed on dementia.

Delirium is a frequent syndrome among patients who are elderly. People who are older with cognitive impairment who are institutionalized are at increased risk of developing delirium when hospitalized. In addition, their prior cognitive impairment makes detecting their delirium a challenge.

Potential interaction between warfarin and boldo-fenugreek.

A patient was treated with warfarin for atrial fibrillation. During treatment, an increase in international normalized ratio (INR) and her admission that she was taking a variety of natural products, to include boldo and fenugreek, led us to suspect that some of these natural products could alter the effect of warfarin. When she stopped the culpable products, the INR returned to normal after 1 week.